Quality, Rigor, and Outcomes of Antecedent Exercise Strategies for Supporting Autistic Individuals: A Synthesis and Multilevel Meta-Analysis

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Bibliographic Details
Title: Quality, Rigor, and Outcomes of Antecedent Exercise Strategies for Supporting Autistic Individuals: A Synthesis and Multilevel Meta-Analysis
Language: English
Authors: Art Dowdy (ORCID 0000-0001-6466-6774), Saehee An, Fernando Roldan
Source: Exceptional Children. 2026 92(4):463-482.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 20
Publication Date: 2026
Document Type: Journal Articles
Information Analyses
Reports - Research
Descriptors: Autism Spectrum Disorders, Literature Reviews, Exercise, Intervention, Behavior, Behavior Modification, Self Control, Exceptional Child Research, Response to Intervention, Meta Analysis, Physical Activity Level
DOI: 10.1177/00144029251386292
ISSN: 0014-4029
2163-5560
Abstract: Physical activity is a promising strategy for strengthening behavior and social engagement through its physiological and psychological benefits. Antecedent Exercise (AE) is a structured behavioral intervention aimed at mitigating meltdowns and promoting adaptive behaviors in Autistic individuals. This synthesis and multilevel meta-analysis of 34 studies, including diverse settings and exercise types, provides a nuanced examination of AE's effectiveness. AE demonstrated moderate efficacy with effect sizes of -0.342 (SE = 0.089, p < 0.005, 95% CI [-0.517, -0.168]) for reducing meltdowns, and a substantial improvement of 0.806 (SE = 0.166, p < 0.005, 95% CI [0.481, 1.13]) for increasing adaptive behaviors. Special education settings such as day centers and schools yielded robust outcomes, thus highlighting AE's effectiveness in an educational context. Interventions involving accessible activities like aerobic exercise routines and jogging also showed to be effective. Despite variability in study rigor and some indications of publication bias, AE appears to be a scalable intervention for educators and clinicians. Future research should address the long-term maintenance effects and optimal implementation strategies for maximizing AE's benefits in educational and clinical settings. This evidence supports the integration of AE into practices for improving the quality of life and educational outcomes for Autistic individuals.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1508137
Database: ERIC
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Abstract:Physical activity is a promising strategy for strengthening behavior and social engagement through its physiological and psychological benefits. Antecedent Exercise (AE) is a structured behavioral intervention aimed at mitigating meltdowns and promoting adaptive behaviors in Autistic individuals. This synthesis and multilevel meta-analysis of 34 studies, including diverse settings and exercise types, provides a nuanced examination of AE's effectiveness. AE demonstrated moderate efficacy with effect sizes of -0.342 (SE = 0.089, p < 0.005, 95% CI [-0.517, -0.168]) for reducing meltdowns, and a substantial improvement of 0.806 (SE = 0.166, p < 0.005, 95% CI [0.481, 1.13]) for increasing adaptive behaviors. Special education settings such as day centers and schools yielded robust outcomes, thus highlighting AE's effectiveness in an educational context. Interventions involving accessible activities like aerobic exercise routines and jogging also showed to be effective. Despite variability in study rigor and some indications of publication bias, AE appears to be a scalable intervention for educators and clinicians. Future research should address the long-term maintenance effects and optimal implementation strategies for maximizing AE's benefits in educational and clinical settings. This evidence supports the integration of AE into practices for improving the quality of life and educational outcomes for Autistic individuals.
ISSN:0014-4029
2163-5560
DOI:10.1177/00144029251386292